Dental

Books and taxes for orthodontists.

Records fees, treatment plan down payments, monthly installments, and aligner case fees that do not belong with the lab bill. Gus sorts every deposit, an accountant checks every transaction, and you get one number each month.

Book a call What we handle
  • From $197 a month
  • An accountant on every transaction
  • Cancel whenever
JuneExample month
$27,500
what you made

June made $27,500. I kept the aligner case fees to Align Technology apart from your regular lab bill, so you can see what clear aligners are really costing against wire and bracket cases.

  • New patient records feeRecords and exam fees
  • Monthly installment paymentIn-house payment plans
  • Align Technology invoiceAligner case fees
  • Ortho lab billLab fees
  • Weave texting subscriptionPractice software
Money in$71,000
Money out$43,500
Set aside for taxes$6,200
An example month. Yours will have your numbers.

Why your books are different

An orthodontic practice's books go wrong in four familiar places.

Your practice runs on treatment plans that pay out over a year or two, not single visits. A generalist bookkeeper who counts a big upfront payment as one month's income gets your busiest and slowest months backwards.

  1. 1

    A treatment plan payment is not one month's income

    A patient pays $5,800 upfront for 20 months of adjustments. Counted as this month's income, a slow month for new starts looks fine and a heavy month of starts looks inflated, when neither reflects the work actually done.

    What we doRecords the deposit as it lands and flags large upfront payments tied to multi-month treatment, so the accountant decides how it is counted at tax time.
  2. 2

    Aligner fees and lab fees blur together

    A per-case fee to Align Technology for clear aligners and a wire-and-bracket lab bill are priced completely differently, but lumped into one lab line, you cannot tell which type of case is actually more profitable.

    What we doKeeps aligner case fees and traditional lab bills in separate categories so you can compare the two.
  3. 3

    Payment plan installments need their own tracking

    Most patients pay in monthly installments over a year or two, not all at once. A generalist bookkeeper who only sees deposits cannot tell a new case starting from an old one still paying off.

    What we doTracks installment income against the case it belongs to, so a batch of new starts is not confused with old plans finishing up.
  4. 4

    Records fees get folded into treatment revenue

    The separate fee for records, photos, and the initial exam is a different kind of income than the treatment fee itself, and blending them hides how many consults are actually converting to starts.

    What we doKeeps records and exam fees in their own category, apart from treatment plan payments.

Your categories

The categories Gus keeps for an orthodontic practice.

Set up once for how the practice gets paid and what it spends. You never pick a category. He does, and an accountant checks it.

Money in

  • Records and exam feesThe separate charge for the initial exam, photos, and treatment plan.
  • New treatment plan paymentsThe upfront or down payment when a patient starts braces or Invisalign.
  • Payment plan installmentsMonthly payments from patients partway through treatment.
  • Insurance paymentsOrthodontic insurance riders, usually a fixed lifetime amount rather than a percentage.

Money out

  • Aligner case feesPer-case fees to Align Technology for clear aligner treatment.
  • Lab feesWires, brackets, retainers, and appliances from the orthodontic lab.
  • Clinical staff payAssistants and any associate orthodontist, kept apart from front desk pay.
  • Practice and scheduling softwareOrtho-specific practice software plus a patient texting service.
  • MarketingGoogle ads, school partnerships, and referral thank-yous to general dentists.
  • Financing feesWhat CareCredit or an in-house financing partner keeps on a payment plan.

What we watch for you

  • New starts

    How many patients begin treatment each month, the clearest sign of where revenue is headed.

  • Case fee share

    Aligner and lab fees against collections, since case mix changes what a typical month costs.

  • Plan collections

    How much of what is owed on active payment plans actually gets collected each month.

  • The set-aside

    What you owe as new starts and old payment plans shift the number, tracked so April holds no surprise.

Ask Gus

Things orthodontists ask Gus.

Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.

A patient starts braces and pays $1,200 down with the rest over 20 months. How does that count as income?

I record the $1,200 as it lands and flag the plan so the accountant can decide how the rest is treated as it comes in over the next 20 months.

Why does my lab bill look so different from my aligner costs?

They are priced differently. I keep Align Technology's case fees apart from your wire and bracket lab bills so you can see which type of case is really more profitable.

New starts were slow this month but installments still came in. Is that a problem?

Not at all. That is old cases paying off while new starts caught their breath. I keep those two separate so a slow month for starts does not look like a slow month overall.

The tax side

The tax side of an orthodontic practice.

Most of what goes wrong here is timing. A big upfront payment for two years of treatment is not automatically this year's income, and the accountant needs the whole picture to sort it out.

What your return has to get right

Your accountant signs it, so it gets done right the first time.

  • Multi-month treatment paymentsA large upfront or down payment for treatment spread over many months is not automatically all this year's income. The accountant sorts out the timing based on the whole practice's year.
  • Equipment and imagingA cephalometric x-ray unit or 3D scanner can usually be written off the year you buy it. Bonus depreciation is 100 percent for property bought after January 19, 2025.
  • Associate orthodontist classificationAn associate orthodontist paid on production is usually an employee, not a contractor, and state rules on who can own a dental practice narrow the options further.
  • Contractor 1099sA relief orthodontist or a marketing contractor paid $2,000 or more in 2026 who is not on payroll gets a 1099-NEC by January 31.

Deductions orthodontists miss

Your bookkeeper knows what to look for in your statements. You never have to.

  • Retainer and appliance materials
  • Cephalometric x-ray costs
  • Loupes and headlights
  • Malpractice insurance
  • Practice software subscriptions
  • Patient texting service
  • Referral thank-you gifts
  • Continuing education
  • Orthodontic association dues
  • Marketing and website costs
  • Financing merchant fees

General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.

All year, not just April

An orthodontic year, kept every month.

New starts move with the school calendar. Your taxes move on the calendar's schedule. Your team keeps you ahead of both. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.

  1. January

    Plan the new year

    Last year's return gets started, the contractor list for any relief orthodontist is ready, and a monthly set-aside begins so April is not a scramble.

  2. April

    Return filed

    Your business return is filed and signed. The set-aside running since January covers what is due, no scrambling required.

  3. July

    Summer surge check

    Summer is the busiest stretch for new starts while kids are out of school. Gus checks where the practice stands and what the rest of the year looks like.

  4. October

    Before the slow stretch

    New starts often dip around the holidays. Before that hits, Gus flags equipment worth buying and anything worth doing before December.

What you get

Starts at$197a month

What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.

Book a call
  • Monthly bookkeeping

    Every transaction sorted into categories set up for orthodontists. You never categorize a thing.

  • An accountant checks every transaction

    Real review, every month, before your books close. Not a spot check.

  • Your business tax return, filed

    Prepared, reviewed, and signed by that same accountant every year.

  • The monthly number

    What you made, what you spent, what to set aside for taxes.

  • Your own bookkeeper

    A real person assigned to your business, in the app whenever you need them. No hold music.

  • On your books all year

    Every month, not just in April. Your team speaks up whenever something is worth your attention.

  • Cancel any time

    No contract. No cancellation call. Your books are yours.

Straight answers

Questions orthodontists ask first.

How do you handle a patient who pays for two years of treatment upfront?

The payment is recorded when it lands, and Gus flags large upfront payments tied to multi-month treatment plans so the accountant can decide how that income is treated at tax time.

Do you separate Invisalign costs from traditional braces costs?

Yes. Align Technology's per-case fees are kept apart from your wire and bracket lab bills, so you can see which type of case is actually more profitable to run.

Collections on old payment plans do not match new starts each month. Is that a problem?

No, that is normal. Gus tracks new treatment starts and installment collections on existing plans as separate things, so one does not get mistaken for the other.

Can Gus tell me if my referral marketing is actually working?

He can show you what marketing costs against new starts each month. Whether a specific referral source is working is more of a conversation than a number, but the cost side is always visible.

My books are behind because I just switched practice software. Can Gus catch up?

Yes. Send the bank statements you have from the period in question. Gus sorts through what is there and the accountant reviews it once it is caught up.

Is a real accountant checking my books?

Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.

What does it cost, and can I cancel?

It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.

More in dental

We keep books for the business next door too.

What makes a bookkeeper worth paying for Every business we keep books for

Book a call

Pick a time. That's the whole signup.

Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.

  • $197 a month to start
  • An accountant on every transaction
  • Cancel whenever